title: Influence of urine volume on the assessment of intestinal permeability in affected children by multiple sugar probes.
abstract: BACKGROUND
  In this study we have looked at the reliability of a multi-sugar test in a pediatric patient population and its accuracy at small urine volumes to evaluate intestinal permeability.
  
  
  METHODS
  Out of 117 subjects enrolled, 31 were healthy and 86 were sick. A solution containing lactulose, rhamnose, sucrose, and sucralose was administered to subjects who were on fasting; the urine excreted during 5 h was collected and measured. Samples were analyzed by gas chromatography-tandem mass spectrometry and results were expressed as percentage of sugar recoveries and lactulose/rhamnose (L/R) ratio.
  
  
  RESULTS
  The analyses showed a clear effect of low urinary volumes (≤240 mL) particularly affecting rhamnose excretion in healthy subjects and sucrose and sucralose recovery in diseased children. Despite the low rhamnose recovery, as lactulose is not similarly affected, the diagnostic reliability of L/R ratio is well preserved at low diuresis conditions. However, this ratio can be useful to discriminate acute conditions vs. clinical remissions only at high urine volumes. Data also suggest potential diagnostic applicability of sucrose and sucralose in children at high urine volumes.
  
  
  CONCLUSIONS
  In conclusion, the multi-sugar test has a good predictivity in pediatric subjects but results must be carefully interpreted in the face of reduced diuresis.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Addobbati
authors.forename: Lorella
authors.initials: L
authors.lastname: Pascolo
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Toro
authors.forename: Giulia B
authors.initials: GB
authors.lastname: Sebastiani
authors.forename: Stefano
authors.initials: S
authors.lastname: Martellossi
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Not
mesh_terms: D002241:Carbohydrates / Q000652:urine*; D002675:Child, Preschool; D004231:Diuresis; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D005767:Gastrointestinal Diseases / Q000473:pathology / Q000652:urine; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000378:metabolism*; D007792:Lactulose / Q000652:urine; D008297:Male; D010539:Permeability; D012210:Rhamnose / Q000652:urine; D013395:Sucrose / Q000031:analogs & derivatives / Q000652:urine
chemical_list: D002241:Carbohydrates; D007792:Lactulose; D013395:Sucrose; C026285:trichlorosucrose; D012210:Rhamnose